Revista de Gastroenterología de México Revista de Gastroenterología de México
DOI: 10.1016/j.rgmxen.2018.04.007
Clinical image in Gastroenterology
Diverticulitis with a giant colonic diverticulum
Diverticulitis de divertículo gigante de colon
S. Sánchez-García, , D. Rubio-Solís, B. Argüelles-García
Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

An 83-year-old woman came to the emergency service complaining of abdominal pain in the right iliac fossa (RIF) of 48-h progression. Abdominal x-ray identified a rounded, radiolucent structure in the RIF (fig. 1). A computed tomography (CT) scan showed that the structure communicated with the sigmoid colon, corresponding to a 9-cm diverticulum with signs of inflammation (fig. 2). Treatment consisted of initial antibiotic therapy, followed by sigmoidectomy with exeresis of the diverticulum. A giant diverticulum is that which is larger than 4cm. It is a rare manifestation of diverticular disease, whose cause is unclear. A unidirectional valve is thought to be created between the colon and the diverticulum in which air is trapped, resulting in the gradual distension of the diverticulum. Clinical presentation ranges from an asymptomatic abdominal mass to acute abdomen, and pain is the most frequent symptom. A giant diverticulum can present with complications of perforation, inflammation, bleeding, and neoplastic degeneration. CT is the most accurate study for demonstrating the communication of the diverticulum with the colon and the possible complications.

Figure 1.

Plain abdominal x-ray identifying a localized, rounded, radiolucent structure in the RIF (arrows).

Figure 2.

A) Axial view of the abdominal CT scan. A cystic lesion is seen in the RIF (*), with thickened walls (arrows) and inflammatory changes in the surrounding fat (arrowhead). B) Coronal reconstruction of the abdominal CT scan. The communication of that structure (*) with the sigmoid colon (arrow) is confirmed, corresponding to an inflamed giant diverticulum of the sigmoid colon.

Financial disclosure

No financial support was received in relation to this article.

Conflict of interest

The authors declare that there is no conflict of interest.

Please cite this article as: Sánchez-García S, Rubio-Solís D, Argüelles-García B. Diverticulitis de divertículo gigante de colon. Revista de Gastroenterología de México. 2018.

Corresponding author at: Telephone: +636940833. (S. Sánchez-García
DOI: 10.1016/j.rgmxen.2018.04.007